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FLUID AND ELECTROLYTE BALANCE

FLUID AND ELECTROLYTE BALANCE. BY DR M AL-AMOODI. BODY FLUID COMPT. INTRACELLULAR FLUID(60% BODY WEIGHT) EXTRACELLULAR FLUID (40% BODY WEIGHT) 50-70% TOTAL BODY WEIGHT IS WATER. EXTRACELLULAR FLUID. INTERSTITIAL FLUID INTRAVASCULAR FLUID(PLASMA PART OF BLOOD). FLUID/ELECT REQ/DAY.

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FLUID AND ELECTROLYTE BALANCE

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  1. FLUID AND ELECTROLYTE BALANCE BY DR M AL-AMOODI

  2. BODY FLUID COMPT • INTRACELLULAR FLUID(60% BODY WEIGHT) • EXTRACELLULAR FLUID (40% BODY WEIGHT) • 50-70% TOTAL BODY WEIGHT IS WATER

  3. EXTRACELLULAR FLUID • INTERSTITIAL FLUID • INTRAVASCULAR FLUID(PLASMA PART OF BLOOD)

  4. FLUID/ELECT REQ/DAY • 35 cc/kg/day or 1500cc/m/day • Na 100 mmol • K 70 MMOL

  5. FLUID TUNROVER • G.I • 6000-9000 cc/day • 200-400cc/day • RENAL 1000-1500cc/day • INSENSIBLE LOSSES 400cc/m/day or 600-800cc/day(60% as water vapor from lungs;40% as perspiration and water vapor from skin.

  6. FLUID BALANCE • REQUIRES 1.NORMAL DAILY REQ 2.REPLACEMENT OF ONGOING LOSSES 3.CORRECTION OF ABNORMALITIES

  7. Increased requirements in patients with abnormal losses e.g fever 15% increase in insensible losses for each 1c above 37

  8. Assessment • History • Physical exam • Laboratory • Urine output should be 0.5-1.0 cc/kg/hr

  9. VOLUME DISORDERS • HYPOVOLAEMIA shock-8% TBW loss,>40% blood volume • Signs and symptoms mental status changes-sleepiness cardiac-tachycardia,decreasedcvp ,ect Also oligouria,weakness

  10. TYPES OF FLUIDS • NON –BLOOD • 0.9% SALINE/ 1:150MMOL Na –ISOTONIC • 5% DEXTROSE/ 1:278MMOL GLUCOSE- ISOTONIC • DS /1:30MMOL Na ;4% GLU(222mmol)=

  11. Crystalloids :saline,dextrose,hartmann’s(ringer’s lactate),ringer’s solution • Ringer’s(Na 147,Cl 156, k 4, Ca 2.2 • Hart (Na 131, Cl 111, k 5, Ca 2,Hco3 29mmol as lactate) • Colloids : Dextran,gelatin,starch

  12. CLINICAL FEATURES • LOW Na : CELLULAR OVERHYDRATION: CONFUSION, FITS • WATER EXCESS: HYPERTENSION,CARDIAC FAILURE,OEDEMA,ANOREXIA,NAUSEA, MUSCLE WEAKNESS • HIGH Na : THIRST,,CONFUSION,COMA • LOW K :MUSCLE WEAKNESS, FATIGUE,DECREASED DEEP TENDON REFLEXES,PARALYTIC ILEUS

  13. ACID-BASE • METABOLIC ACIDOSIS • METABOLIC ALKALOSIS • RESPIRATORY ACIDOSIS • RESPIRATORY ALKALOSIS

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